[Diagnosis and therapy of idiopathic thrombocytopenic purpura]

To the diagnostics of the idiopathic thrombopenia caused by autoantibodies belong: 1. the clinical findings such as type of haemorrhage and the controls of the capillary function. 2. the proof of antibodies, in which case positive findings are proving, but negative ones do not exclude the immune thrombopenia, 3. smear of the sternal marrow with judgment of the megakaryocytes and formation of thrombocytes, 4. isotopic control of the survival time of the thrombocytes, which is reserved to special insitutions. As therapy essentially three forms have developed: 1. Therapy with glucocorticoids, 2. Immunosuppressive drugs, 3. Splenectomy. In own observations of 48 patients the glucocorticoids bring an actual improvement only for 7 patients, the others fail in therapy or show only a partial remission. The least prospects are in the immunosuppressive drugs, being equal whether preceding or accompanying a glucocorticoid therapy was performed. Most successes (11 out of 16 patients) are to be stated in splenectomy. Following an after-control of all therapeutic methods together a successful therapy results only in one third, in the next two thirds the therapy either fails or at most evokes a partial remission.